Pharmacosex: Reimagining sex, drugs and enhancement

Sexualized drug use and chemsex: A bibliometric and content analysis of published literature

Sexualized drug use (SDU) describes drug-facilitated sexual enhancement, and chemsex is an SDU subculture involving the use of specific drugs by men who have sex with men (MSM). This study aimed to identify research trends, foci, and themes within the SDU and chemsex-specific literature. The Web of Science Core Collection was searched with a list of SDU synonyms. All SDU-related articles were analyzed using the R package, bibliometrix. Full text review identified chemsex-specific records, and text was extracted verbatim for content analysis in Leximancer. The search returned 1,866 unique records. A total of 521 addressed SDU, and 301 papers specifically addressed chemsex. The small but growing SDU literature primarily addressed consensual encounters between MSM, and drug-facilitated assault experienced by women, in Western settings. Little attention was given to transgender communities or consensual SDU in cisgender heterosexual individuals. The literature primarily viewed SDU through a public health lens, specifically focusing on the risk conferred to sexual health.The SDU and chemsex-specific literature are potentially limited in scope and may inadequately capture the geographical, demographic, and cultural diversity of these phenomena. Future research should address the myriad social and health implications of SDU and chemsex participation across all relevant communities and settings.

Discrimination, gender dysphoria, drinking to cope, and alcohol harms in the UK trans and non-binary community

Transgender (trans) and non-binary people may be at increased risk of alcohol harms, but little is known about motives for drinking in this community. This study explored the relationship between risk of alcohol dependence, experience of alcohol harms, drinking motives, dysphoria, and discrimination within a United Kingdom sample of trans and non-binary people with a lifetime history of alcohol use. A cross-sectional survey was co-produced with community stakeholders and administered to a purposive sample of trans and non-binary people from 1 February until 31 March 2022. A total of 462 respondents were included-159 identified as non-binary and/or genderqueer (identities outside the man/woman binary), 135 solely as women, 63 solely as men, 15 as another gender identity, 90 selected multiple identities. Higher levels of reported discrimination were associated with higher risk of dependence and more reported harms from drinking. Coping motives, enhancement motives, and drinking to manage dysphoria were associated with higher Alcohol Use Disorders Identification Test scores. Social, coping, and enhancement motives alongside discrimination and drinking to have sex were associated with harms. The relationship between discrimination and risk of dependence was mediated by coping motives and drinking to manage dysphoria. Further to these associations, we suggest that reducing discrimination against trans and non-binary communities might reduce alcohol harms in this population. Interventions should target enhancement motives, coping motives and gender dysphoria. Social and enhancement functions of alcohol could be replaced by alcohol free supportive social spaces.

Kink in an English Field: The Drinking, Drug use and Sexual Practices of English Festival-Goers Who Engage in Kink

Little is known about the other leisure activities of people who engage in kink, including sexual practices and the use of alcohol and other drugs. This article examines the drinking, illicit drug use and sexual practices of people who engage in kink from a novel sample of attendees at an English festival. Of 966 respondents, 64 reported having engaged in kink within the past 12 months. We provide evidence of these respondents' self-reported demographic characteristics, alcohol and other drug use in their lifetime and within the past 12 months, as well as other sexual practices they engaged in. This study illustrates the value of accessing participants through in situ festival fieldwork to understand kink practices, and helps us move beyond notions of clustered risky activities toward a leisure studies approach to understanding the practices of people who engage in kink.

Mental Health Symptoms Associated with Sexualized Drug Use (Chemsex) among Men Who Have Sex with Men: A Systematic Review

Background: Sexualized drug use (SDU), also known as chemsex, refers to the use of psychoactive substances for sexual purposes among men who have sex with men (MSM), which has been associated with mental health symptoms. The objective of this review is to systematically review the available evidence on mental health outcomes in MSM who use sexualized drugs. Methods: To prepare this systematic review, search strategies were developed and applied to the Web of Science, Science Direct, PubMed, and Scopus databases. A total of 117 articles were found, of which 12 were selected for the final review. Results: Those MSM who practiced SDU were more likely to experience from depression, anxiety, or a substance dependence, although these results were not found in all the studies analyzed. Among those who practiced the administration of intravenous drugs (referred to as slamsex), the mental health symptoms were more severe. Conclusions: This systematic review contributes to a fuller understanding of the mental health symptoms present in MSM who consume drugs for sexual purposes. Greater uniformity in data collection instruments is required, as well as the need to conduct a more in-depth assessment of the psychosocial adjustment of people who practice chemsex.

Sexual excitation and sex-linked substance use predict overall cannabis use in mostly heterosexual and bisexual women

Background: Bisexual and mostly heterosexual women report higher substance use than exclusively heterosexual or lesbian women. In sexual minority men, sex-linked substance use (SLSU) can increase risk for substance use problems; equivalent research in women is lacking.Objectives: To test if sexual excitation and inhibition mediate the association between sexual minority status and women's SLSU.Methods: We surveyed a convenience sample of 595 undergraduate women who identified as exclusively heterosexual (n = 499), mostly heterosexual (n = 59), or bisexual (n = 37). Participants reported on their last month use of alcohol, cannabis, and other drugs (e.g., cocaine) in sexual and non-sexual contexts, and symptoms of alcohol and non-alcohol drug use disorders (e.g., withdrawal symptoms). Drug use symptoms were collapsed across non-alcohol substances. We used structural equation modeling to test serial mediations of women's SLSU and overall drug and alcohol use.Results: Bisexual and mostly heterosexual women reported higher cannabis use (η2 = 0.030) and drug use disorder symptoms (η2 = 0.050) than heterosexual women. Mostly heterosexual women's SLSU was a stronger predictor of alcohol use (η2 = 0.019) and binge drinking frequency (η2 = 0.015) than for other orientation groups. Bisexual and mostly heterosexual women's higher sexual excitation predicted their higher SLSU, which in turn predicted higher cannabis use frequency and drug use disorder symptoms. However, sexual inhibition failed to mediate either SLSU or overall substance use.Conclusion: These findings point to SLSU as a mechanism by which sexual minority women may experience disparities in substance use related harms.